The law states that, beginning in 2014, individuals must ensure that they and their dependents are covered by health insurance. Taxpayers who do not meet this requirement will have to pay a penalty that the law calls a “shared responsibility payment.” It begins at $95 for the first year and never exceeds 2 1/2 percent of anyone’s annual taxable income.

A large majority of Americans, of course, have health insurance through their employers, Medicare or Medicaid and are already in compliance with this requirement. Given the relatively modest payment required of those who choose not to maintain insurance, no one is being forced to buy a product they don’t want.

The challengers argue that the mandate is a binding requirement that makes anyone who goes without insurance a lawbreaker. The government has determined, however, that those who pay the penalty, like those who are exempt from the penalty, are not lawbreakers. As a practical matter, the so-called mandate is just a relatively modest financial incentive to have health insurance.

First, the "myth" refers to whether people are forced to buy insurance, not whether people are "made" into "lawbreakers." It's odd that he's introducing this "lawbreaker" concept. Second, what exactly has "the government... determined"? Dellinger is making it sound as though getting labeled a "lawbreaker" is some problem that the government is saving us from, but I think he only means that the government has given people an out — that people who don't buy are not breaking the law as long as they pay the "penalty." But the term "penalty" implies that you've done something wrong.

Are people who care about being law-abiding supposed to feel free not to buy insurance and simply pay the penalty? Presumably, Dellinger is saying yes, as if people who feel the rules apply to them are just being silly. For example, do you feel "forced" to follow the speed limit? Would Dellinger say you're not forced, because you have the option of paying speeding tickets? I don't think he would, and I'm sure he wouldn't assert that you're not even breaking the law when you speed as long as you pay your speeding tickets!

But perhaps Dellinger would say that what's different about the Obamacare penalty is that it's such a small amount. By contrast, speeding tickets are much more painful than the benefit of speeding, and after a few of them, you lose your license entirely. The Obamacare penalty is an attractive option. It's a way of life. It's pretty much just a little tax to swallow. The option of actually buying insurance will be forgone. It would make more sense to say you're forced to pay a new tax than you're forced to buy insurance. And what a tiny little tax! "It begins at $95 for the first year and never exceeds 2 1/2 percent of anyone’s annual taxable income."

So Obamacare doesn't work to get the uninsured insured, it just gives the federal government a new source of revenue. Meanwhile, these uninsured folks can buy insurance at whatever point they want, right? Whenever they acquire a condition that makes them want to have insurance, they can take advantage of private insurance companies that never got the benefit of the "penalty" these people were paying to the federal government all these years. So this scheme will destroy private insurance companies and is really a way to leverage in, by steps, a completely government-controlled health-care system. Or have I arrived at another "myth" that Dellinger can rescue me from?

Nope. The closest thing on his list is #4: "The law is socialist." But here, Dellinger says it's not "the New Deal approach of having a monolithic government agency be the single provider of a good or service." (Whoa! Did he just accidentally call the New Deal "socialist"?)

Instead, the law adopts a new approach, one conservatives have long supported, of using providers in the private market to deal with social and economic problems.

Initially, yes, but it's not going to work, and many people suspect we're simply entering Phase 1, which seems more acceptable, but it's built to fail — that's the plan — and when it does, at Phase 2, the American people will accept the "socialist" solution, which they would not have accepted at the outset, because there will be no way to restore the private insurance business destroyed in Phase 1. Now, I have heard this conspiracy theory stated many times — e.g., by Rush Limbaugh — and I am certain Dellinger knows it. And yet it does not appear on his lists of myths. The inference is clear:

For example, do you feel "forced" to follow the speed limit? Would Dellinger say you're not forced, because you have the option of paying speeding tickets?

For a law professor, you sure don't know much about the law. Speeding is a criminal violation. Granted, most are dealt with with simply a fine, but if you are going too fast or accumulate too many speeding tickets there are other sanctions such as losing your license of if the speed is reckless, even ending up in jail.

" Given the relatively modest payment required of those who choose not to maintain insurance, no one is being forced to buy a product they don’t want...."

Isn't one part of Obamacare that you can't be turned down for insurance? So you can pay the cheaper penalty and not buy insurance and then you break a leg or get cancer then you can sign up for insurance coverage.

Reform is the key word Althouse. Keep saying that word - the libs are just reforming our health care system because their previous big reforms like soc sec and Medicare and Medicaid have worked so well and are in excellent financial shape. Reform - trust them - it is for our own good.

For a law professor, you sure don't know much about the law. Speeding is a criminal violation.

At least where I live in Virginia, only one kind of speeding (violating the "Basic Speed Rule") is a crime; the others are civil violations with penalties laid out in law, just like not having insurance is under PPACA.

then you break a leg or get cancer then you can sign up for insurance coverage.

If you break your leg, you are not going to have time to sign up for insurance before you have it set. As for cancer, although you can't be denied coverage I don't believe the prohibits insurance companies from charging based on the relative risk. So, I bet if you waited for the diagnosis, the insurance company will say "sure we'll cover you--for a million dollars a year."

The issue is what constitutes "breaking the law," not what is a criminal violation.

Dellinger asserts that the government has "determined" that someone who pays the penalty for failing to do something the law requires him to do is not "breaking the law."

Explain what he means.

You don't have to worry about my analogy. You can just explain what he means outright. My comparison is there for the purpose of clarifying the assertion he's making. If it doesn't clarify for you, just advance to the actual question at issue: if "the law states that individuals must ensure that they and their dependents are covered by health insurance" and someone fails to do so, how is it that they have not broken the law? Why is the consequence — here, a penalty — something that causes it to be the case that the person has not broken the law.

And spare me the bullshit insults like "For a law professor, you sure don't know much about the law." You're just larding up your argument.

I want some clear speech, straight to the issue, without evasions, sidetracks, and insults.

And I will interpret all unclarity and failure to respond as evidence that you CANNOT respond.

Of course, Althouse didn't take it far enough. What about those who choose not to buy insurance and refuse to pay the penalty? What is the consequence then?

I'm also stuck on how much oversight and enforcement is going to cost. How many thousands of new jobs will be created just for "insurance verification", "penalty assessment" and collection enforcement -- jobs that have no reason to exist yet taxpayers must fund. Idiotic!

"Given the relatively modest payment required of those who choose not to maintain insurance, no one is being forced to buy a product they don’t want."

Yeah, it's only a little force, so it doesn't really count, see?

My electric bill budget-pay just went from $89 to $152 per month, a $63 increase. I don't consider that a "relatively modest payment" and I'm actually getting something for it, unlike the vapor provided by the mandate's "penalty."

Freder - no, speeding is not, for the most part, and in most states, a crime. I think that it used to be, but the last thing that the state (generically) is for an alleged speeder to demand criminal protections. I remember when I could demand a jury trial for simple speeding, and, yes, did. I have also made discovery requests in traffic matters. Or, that pesky beyond-a-reasonable-doubt standard, which is pretty hard to obtain in photo-radar tickets.

Now, there is a level of speeding that may result in you being hauled off to jail (unless you are an illegal driving in CA - they apparently also don't need insurance either). Watching a Mark Harmon TV movie last night where he was pulled over for 60 over. And, yes, 40 years ago, I came close to that a couple of times.

"those who pay the penalty, like those who are exempt from the penalty, are not lawbreakers"

Sure, if they pay the penalty, they are not breaking the law, they are following the law.

But the issue is the imposition of the penalty in the first place. One is not penalized for complying with this law, the penalty is for failing to comply with the law -- for breaking the law -- to obtain insurance whether you want it or not, whether you need it or not, and not just any insurance, but the insurance that Kathleen Sebelius dictates that you get.

And, of course, failure to pay the penalty -- a penal sanction which is imposed automatically without any procedural due process of law -- that is a violation of the law, for which the government will come seize your assets or throw you in jail.

"...(M)any people suspect we're simply entering Phase 1, which seems more acceptable, but it's built to fail —that's the plan —and when it does, at Phase 2, the American people will accept the "socialist" solution, which they would not have accepted at the outset, because there will be no way to restore the private insurance business destroyed in Phase 1. Now, I have heard this conspiracy theory stated many times —e.g., by Rush Limbaugh —,and I am certain Dellinger knows it. And yet it does not appear on his lists of myths. The inference is clear:

"It's not a myth!"

What inference? Which myth? Clear to whom?

You seem to be referring to a "conspiracy theory" stated by Rush Limbaugh, not one of the Dellinger-described "myths."

and the Brits have had the National Health Service (which I do not think is quite as far-reaching as the Reid-Pelosi plan) since 1948, and fighting over it still takes up more time and effort in Parliament than all other issues combined, to judge by watching "Prime Minister's Questions" on C-Span.

A lot of people ignore, or don't realize, that health insurance companies don't want to be in the insurance business. They want to be in the "administrative service organization" business where they administer the plan but the taxpayers actually pay the claims. They support Obamacare, as long as the fees they will charge are enough. They are a bit like GE making solar energy products. If the government will guarantee the revenue and pick up the excess costs, they are happy to participate in the Obama fascist program.

Krupp made great cannons and Porche made wonderful tanks (to American design actually) and they were happy to do business with Hitler until the Lancaster bombers started coming over.

"If you break your leg, you are not going to have time to sign up for insurance before you have it set. As for cancer, although you can't be denied coverage I don't believe the prohibits insurance companies from charging based on the relative risk. So, I bet if you waited for the diagnosis, the insurance company will say "sure we'll cover you--for a million dollars a year.""

Freder Frederson, like Garage Mahal, simply does not know what PPACA does, or does not do.

Despite this gross ignorance he, like Garage Mahal, undoubtedly, still supports the law.

And no, I'm not going to help Freder Frederson solve his ignorance problem.

There's not enough time in my lifetime for that, the chance of success is surpassingly small, and rewards of succeeding simply aren't worth the effort.

#ILikeObamacare because whenever the idiots who support it defend it, they only prove their ignorance of what it actually does.

"'then you break a leg or get cancer then you can sign up for insurance coverage.' If you break your leg, you are not going to have time to sign up for insurance before you have it set. As for cancer, although you can't be denied coverage I don't believe the prohibits insurance companies from charging based on the relative risk. So, I bet if you waited for the diagnosis, the insurance company will say "sure we'll cover you--for a million dollars a year.""

It's a key provision of Obamacare that they're required to issue insurance and to use the same premium:

"Guaranteed issue and partial community rating will require insurers to offer the same premium to all applicants of the same age and geographical location without regard to most pre-existing conditions (excluding tobacco use).[17]"

If you have a good idea, and it's clearly good, then why would you need to change the meaning of words and get into the minutia of semantics about the primary points. It almost sounds like someone is trying to lie, or there are lots of lawyers involved, which is the same thing.

3. If the court upholds the health-care law, it means Congress has the power to require Americans to purchase any product.

The health-care case is a test of Congress’s power under the Constitution to regulate commerce among the states. One way to defend the law is simply to say that a requirement to purchase insurance or any other product sold in interstate commerce is obviously a regulation of that commerce...

The Obama administration is not relying upon such a sweeping argument, however, and its more limited claim would not justify any law that required Americans to buy products such as cars or broccoli.

The mandate does not force people into commerce who would otherwise remain outside it. Instead, it regulates the consumption of health care, an activity in which virtually everyone will engage. Right now, people who go without insurance often shift the costs of their health care to other patients and taxpayers. That situation is different from what happens with any other type of purchase.

Would the government’s defense of the mandate also support a law requiring Americans to buy broccoli or a car? The answer is a simple and emphatic no.

First note "Instead, it regulates the consumption of health care, an activity in which virtually everyone will engage." A lot of problems with this. First, we are talking health care insurance, not health care. Secondly, "virtually everyone" is an admission that not everyone will utilize health care. And, a resort to communitarianism, which means that individual rights are far less important than the good of the community. He is essentially saying, so what if some people won't ever use modern health care - most will, and that is what is important.

This is an extraordinarily weak counter to the slippery slope argument. And, in the end, he resorts to argument by "because I say so". He said that precedent allowing the individual mandate would not open up the possibility for requiring broccoli be eaten, and that is the end of discussion. And he does it twice, for emphasis, as if repeating a bad argument makes it more credible.

And, this is one of the weaknesses that has been attributed to the government's case in favor of the individual mandate - that they failed to provide a viable limiting principle for federal power in their briefs. Which translates into, if they want the Supreme Court to uphold the individual mandate, then they need to come up with a standard under which the federal government could not mandate at least the purchase of broccoli (because, as we all know, it is good for us, and such a mandate would inevitably result in lower overall national health care costs).

""It's not a myth!" What inference? Which myth? Clear to whom? You seem to be referring to a "conspiracy theory" stated by Rush Limbaugh, not one of the Dellinger-described "myths." So is the conspiracy theory a myth, or is it just the conspiracy?"

I don't know why you found the post so difficult to read. Maybe you just don't want to understand.

What would it even mean to say "the conspiracy is/is not a myth"? A myth is an idea about something being true, so what difference would it make to say "the conspiracy theory is a myth" or "the conspiracy is not real"? It's the same thing!

What I was said was "clear" was the inference based on Dellinger's failure to list the conspiracy theory among his myths.

I assert that I'm certain Dellinger knows the argument I've described. Why didn't he put the argument on his list as another one of the "myths"? I can only think of one reason: He can't debunk it. Or maybe: He doesn't want to give it any more publicity than it already has.

Freder Frederson said...For example, do you feel "forced" to follow the speed limit? Would Dellinger say you're not forced, because you have the option of paying speeding tickets?

For a law professor, you sure don't know much about the law. Speeding is a criminal violation. Granted, most are dealt with with simply a fine, but if you are going too fast or accumulate too many speeding tickets there are other sanctions such as losing your license of if the speed is reckless, even ending up in jail.

So your analogy is bad.

3/24/12 12:25 PM

Ar you saying the if upheld the bill is fixed and immutable? The income tax was once only 4% and only at a very high level on of income. Her analogy is correct, yours is wrong.

Liberty is always said to be fatally eroded, it seems, when great advances in social legislation take place. The lawyers who urged the Supreme Court to strike down the Social Security Act of 1935 argued that if Congress could provide a retirement system for everyone 65 and older, it would have the power to set the retirement age at 30 and force the very young to support everyone else.

It was said that if Congress had the authority to create a minimum wage of $5 an hour, it would also be a regulation of commerce to set the minimum at $5,000 an hour. In 1964, critics argued that if Congress could tell restaurant owners not to discriminate on the basis of race, it could tell them what color tablecloths to use. None of these things happened.

Nothing in the health-care law tells doctors what they must say to patients or how those patients are to be treated. It only requires people to either have insurance coverage or pay a modest tax penalty.

Nearly 75 years ago, a Supreme Court dominated by appointees of conservative presidents rejected the challenge to the constitutionality of the Social Security Act. The words of Justice Benjamin Cardozo’s 1937 opinion are relevant today:

“Whether wisdom or unwisdom resides in [the statute in question] it is not for us to say. The answer to such inquiries must come from Congress, not the courts.”

It is hard to come up with all the problems with that. This is supposed to be a counter to the argument that this will reduce liberty, and ends up with an argument about whether or not the courts should be reviewing the wisdom of legislation. And, indeed, throughout this argument, he seems to be confusing the two. The fact that the Congress could legally demand a $5,000 an hour minimum wage has absolutely nothing to do with whether or not individual liberties are impacted. It is only relevant to the wisdom of the legislation, and he seems to be saying that Congress' wisdom is what protects individual liberties.

The problem with that, is that we have a Constitution of limited enumerated powers and a Bill of Rights to protect us and our individual liberties from precisely this problem - a government whose sole limiting principle is the supposed wisdom of its ruling class.

If this all seems a bit muddled, it is because his argument is muddled. Or, really, not an argument at all, but rather, an attempt to conflate several issues.

Freder Frederson said...Now, I have heard this conspiracy theory stated many times — e.g., by Rush Limbaugh — and I am certain Dellinger knows it. And yet it does not appear on his lists of myths. The inference is clear:

It's not a myth!

And how exactly do you debunk a myth--or even bother trying--that has no basis in fact and is just the fevered rambling of right-wing talk show hosts?

3/24/12 12:44 PM

With the non existing facts that you don't have. So far all we have is the fevered ramblings of progressives pissing on our heads and telling us contrary to our lying eyes that its only raining.

The Obama administration is not relying upon such a sweeping argument, however, and its more limited claim would not justify any law that required Americans to buy products such as cars or broccoli.

The mandate does not force people into commerce who would otherwise remain outside it. Instead, it regulates the consumption of health care, an activity in which virtually everyone will engage. Right now, people who go without insurance often shift the costs of their health care to other patients and taxpayers. That situation is different from what happens with any other type of purchase.

Right now, people who go without insurance often shift the costs of their health care to other patients and taxpayers

My oh my! Speaking of shifting costs taken to its logical conclusion his argument is to abolish Medicaid! No Medicaid, no cost shifting.

". Right now, people who go without insurance often shift the costs of their health care to other patients and taxpayers. That situation is different from what happens with any other type of purchase."

Everything you don't buy increases in cost to the others who do buy it. Imagine what an Ipad would cost if there were only 10 customers who wanted to buy one.

The SCOTUS may let this monstrosity live, but as it does, it abandons being an institution that respects the history and calling of the United States. It will complete it's transition into the annals of failed protectors of liberty. Although many will be disappointed, none will be surprised. Freedom is damned hard to hang on to, when you are given the power to give away other peoples' money. That's too intoxicating for most mortals.

"the law states that individuals must ensure that they and their dependents are covered by health insurance" . . .

I want some clear speech, straight to the issue, without evasions, sidetracks, and insults.

And I will interpret all unclarity and failure to respond as evidence that you CANNOT respond.

What happened to your oft-stated policy that just because you don't respond to a post, doesn't mean that you agree with the premise of the post. From now on, when someone calls me a pedophile on this blog (which a couple of immature posters have taken to the last couple of days), I will demand that you tell them to retract the statement. If you don't I will just assume you agree with them.

Regardless, I love it when Professor Althouse gives me an assignment.

So I looked up the text of the individual mandate (Sec 1501 for those of you that are interested):

"IN GENERAL.—øReplaced by section 10106(b)¿ If a taxpayerwho is an applicable individual, or an applicable individualfor whom the taxpayer is liable under paragraph (3),fails to meet the requirement of subsection (a) for 1 or moremonths, then, except as provided in subsection (e), there ishereby imposed on the taxpayer a penalty with respect tosuch failures in the amount determined under subsection (c)."

Now it states very clearly that the only consequence of failing to obtain health insurance is the penalty. In fact further on down in this section (after all the exemptions) is this couple of paragraphs:

‘‘(2) SPECIAL RULES.—Notwithstanding any other provisionof law—‘‘(A) WAIVER OF CRIMINAL PENALTIES.—In the case ofany failure by a taxpayer to timely pay any penalty imposedby this section, such taxpayer shall not be subject to anycriminal prosecution or penalty with respect to such failure.‘‘(B) LIMITATIONS ON LIENS AND LEVIES.—The Secretaryshall not—‘‘(i) file notice of lien with respect to any propertyof a taxpayer by reason of any failure to pay thepenalty imposed by this section, or‘‘(ii) levy on any such property with respect tosuch failure.’’

So not only is the penalty the only consequence of not obtaining insurance, but the law explicitly states there are no criminal penalties for failure to pay, and apparently the government doesn't even have the ability to force payment.

Other than that, I don't know how to be any clearer.

You are hinging your entire argument (once we eliminate the the bad speeding analogy) on "penalty implies you have done something wrong", therefore you are breaking the law by not buying insurance. But what the law does is provide you an option--buy insurance or pay a (apparently uncollectable) penalty.

Oh, and btw Hoosier. I was wrong. The insurance company cannot charge extra for preexisting conditions.

Here's an article from 2010 that serves as a reminder about the trappings of government-run health care. And before lefties disregard it as heresy, note that it comes from another bastion of conservative media, CNN.

Bender said...With respect to myths 1, 4, and 5, these are the kinds of things that Myth Romney has said in defense of RomneyCare.

But doesn't that make "RomneyCare" a powerful constitutional argument against ObamaCare?

How would Dellinger respond if a justice asked him, "why should the federal constitution abide the extraordinary federal regulation of private nonconsumption if the states individually can achieve the same result if they so choose?"

It's a key provision of Obamacare that they're required to issue insurance and to use the same premium:

"Guaranteed issue and partial community rating will require insurers to offer the same premium to all applicants of the same age and geographical location without regard to most pre-existing conditions (excluding tobacco use).[17]"

If you break your leg, you are not going to have time to sign up for insurance before you have it set.

Well, of course not. You pay your local doctor for the cost of setting it. This does happen in other fields.

For example, a bout of really wet snow downed a tree on our property two days ago. We don't have government-mandated tree-removal insurance (possibly because the government hasn't gotten around to that quite yet), so we are paying out-of-pocket for the tree to be cut up and removed.

"Dude, you've talked for two days now about ObamaCare, and you've explained NOTHING about it. Zero. Just snide little talking points you learned from other Acetards. Are we supposed to be impressed?"

Impressed?

You impress yourself by thinking I care if you are impressed or not.

I've explained *why* I explain nothing about the ACA - your and Frederson's oft-demonstrated ignorance of the PPACA is so immense it is exceedingly clear it simply is not worth my time.

In case that was unclear, let me restate it this way: based upon what you and Frederson have said about the ACA, you both do not know enough for me to waste time trying to explain any part of the ACA.

Write something about the ACA that is factually true, that demonstrates you have some real knowledge of the ACA, how it interacts with health care finance and delivery in America, that adds to the conversation - and I'll respond.

Well, of course not. You pay your local doctor for the cost of setting it. This does happen in other fields.

That wasn't the point of that statement. Hoosier Daddy said he would obtain insurance after he broke his leg--that obviously wouldn't work unless you have an incredible tolerance to pain and waited until the insurance kicked in before you got the break set.

There are lots of facets to Obamacare that are regularly ignored by pundits and commentators, who keep repeating and discussing the old canards.

Chief among those ignored facets is that health care is not the same as insurance. It seems that only the Amish and I have understood that for centuries. Neither the Amish nor I are against health care, but we are against insurance in all its ugly forms.

Insurance is simply a mechanism that allows the government to steal income and wealth from the young, healthy, single, childfree male and, after wasting some 20% on administration fees, pass the proceeds to the old, sick, married, breeding female.

Women consume 2/3 of health care. Men much less, and none at all in the several years missed in earlier death. Old folks consume some fantastic percentage like 80% of theirs in the last miserable months of a decent life. Women breed like crazy in their 20s and 30s, each delivery costing some $10000, while the male is at his healthiest and almost never sees a doctor for anything. Many of the non-breeders are ones who have opted for not rearing kids, not supporting the breeding of others, and not sacrificing now for the sake of future generations. Many of folks paying a penalty under Obamacare will be those who live or travel overseas, who, while having to pay, will have no right to medical care at all, as is the situation with Medicaid and Medicare now. There are loads of folks who do not care for Western Allopathy, preferring homeopathy, naturopathy or nullopathy. Why should they be taxed to support the religion of Western Medicine?

In summary, Obamacare represents a major screwjob for those who are healthy, single, childfree, young, male, risk-takers, living overseas who are vegetarians that prefer natural remedies. It steals a great portion of their wealth to support the smoking, drinking, red meat-eating, risk-averse, married and breeding or old female.

I don't believe the prohibits insurance companies from charging based on the relative risk. So, I bet if you waited for the diagnosis, the insurance company will say "sure we'll cover you--for a million dollars a year."

I'm pretty sure premium rates will be regulated by the Feds. The states do it now.

The main point is the financial penalty for not complying with the mandate isn't a sufficient motivator.

In the light of history ... the history of the (d)evoluton of entitlement programs into unsustainable entitlements through political influences, and the stated desire of Mr. Obama and others for a single-payer system ... the "conspiracy theory" at the end the post should not be summarily dismissed as a myth (and for that matter, the addition of de facto "death panels" to the mix should also be considered plausible).

I have repeatedly been challenged by Obamacare proponents with the phrase "the law doesn't say that" ... the problem is, the law can (d)evolve through political pressure into new law that brings forth what opponents have been warning about: a health care system that makes the PATRIOT Act look downright libertarian with respect to the threats it will present to your liberty.

"That wasn't the point of that statement. Hoosier Daddy said he would obtain insurance after he broke his leg--that obviously wouldn't work unless you have an incredible tolerance to pain and waited until the insurance kicked in before you got the break set."

If you knew more about public health programs, you'd understand that Hoosier Daddy is correct.

Insurance is simply a mechanism that allows the government to steal income and wealth from the young, healthy, single, childfree male and, after wasting some 20% on administration fees, pass the proceeds to the old, sick, married, breeding female.

Actually, administration costs of Medicare and Medicaid are around 3%. You must be thinking of private insurance (and that is actually closer to 10% for most).

Then the answer to such attempted "free riding" is to tell Hoosier Daddy to go to hell, he can't have the insurance, and to send him the medical bill instead, rather than using that as a justification for forcing people to buy something they have chosen not to buy.

"What happened to your oft-stated policy that just because you don't respond to a post, doesn't mean that you agree with the premise of the post."

Yeah, it's my blog and I open a forum for people to speak. I don't necessarily respond to everyone.

But you came to MY blog and YOU INSULTED ME. I am taking the trouble to talk to you, and I will make those assumptions about you. You owe me a response here on my blog after the way you spoke to me and after the trouble I took responding to you.

"Then the answer to such attempted "free riding" is to tell Hoosier Daddy to go to hell, he can't have the insurance, and to send him the medical bill instead, rather than using that as a justification for forcing people to buy something they have chosen not to buy."

Right, but if the ACA is allowed to stand, that's not how it's going to work.

Hoosier Daddy and others like his example will be able to buy insurance *after* the accident/illness.

Well, of course, jimbino. Of course it is nothing more than massive income redistribution, taking the wealth of one group to give to other groups.

If the young and healthy who are now forced to buy insurance were to actually seek to obtain treatment -- if they were to want to get their money's worth -- then that would defeat the whole purpose of forcing them to buy into it. They are forced to pay into the system precisely because they do not need it, they pay in and take nothing out. It is all one-way.

If the young and healthy demand $5000 worth of annual services for the $5000 they must pay in each year, if demand for medical care increases along with the supply of money, then the whole system will come crashing down.

I was going to ask whether the politicians enacting this legislation were evil, or just stupid.

What is a bit scary is how badly the legislation was designed. The question is whether that was intentional or inadvertent. And, of course, most of those voting for it had no idea of exactly what they were voting for (and, remember, this guy was trying to argue that the wisdom of the ruling elite is sufficient to protect our individual liberties).

There is something in insurance called "adverse selection". I first learned about this when I was selling health insurance, and had to explain why pregnancy riders were so expensive. The answer was that people added them when they were intending to have kids. So, most of those who had the riders were either trying for kids, or were already on the way. Everyone else skipped it. Large company plans and the like sidestep this problem by completely socializing the cost of pregnancy - everyone pays, and so the cost is spread over everyone on the plan.

Which is why large company, government, etc. policies are going to continue to be somewhat reasonably priced. Up a bit because of the required coverages (like Ms. Flake's free contraceptives). But probably not obnoxiously so.

But, what about everyone else? The individual mandate is not nearly high enough to push that many people into individual policies. And, the revenue from it apparently goes to the general treasury, and not the insurance companies that will be forced to insure these people when they do have something go wrong, and they need health insurance.

So, what I expect to see, if the legislation is not either struck down or repealed, is a horrible adverse selection problem with individual and small group policies. More and more people will opt out if reasonably healthy, and pay the mandate. Then, when they get sick, they will get health insurance to treat their ills. Mandatory issue, no waiting periods, etc. But, the more people who opt out to do this, the worse the problem will be, with the insured population becoming sicker and sicker, and more and more expensive, driving up insurance costs, and forcing more and more people to opt out and pay the penalty instead. A vicious circle, with the equilibrium point likely being beyond the means of many. And individual and small group health insurance moving very quickly from an insurance model to a pre-paid medical expense model.

The reason that I asked the question above is that there has long been a suspicion that the legislation was intentionally designed to destroy the private health insurance market, driving us into a truly socialized medicine system.

You are hinging your entire argument (once we eliminate the the bad speeding analogy) on "penalty implies you have done something wrong", therefore you are breaking the law by not buying insurance. But what the law does is provide you an option--buy insurance or pay a (apparently uncollectable) penalty.

Actually this supports Althouse's "entire" argument, doesn't it?

The argument isn't about whether the rubes pay, it's whether ObamaCare is a scheme that culminates in Phase 2, the destruction of the private health care insurance market. An ineffectual penalty regime would seem to accelerate that process.

So Obamacare doesn't work to get the uninsured insured, it just gives the federal government a new source of revenue. Meanwhile, these uninsured folks can buy insurance at whatever point they want, right? Whenever they acquire a condition that makes them want to have insurance, they can take advantage of private insurance companies that never got the benefit of the "penalty" these people were paying to the federal government all these years. So this scheme will destroy private insurance companies and is really a way to leverage in, by steps, a completely government-controlled health-care system. Or have I arrived at another "myth" that Dellinger can rescue me from?

Well, yes. But the New Deal was socialist, more of the national socialist sort widely favored at the time, but socialist nevertheless. Recognizing the fact today provokes vapors among the power-worshiping lewinsky press, which gets nervous when someone deviates from the script, but, so what?

That the present state-mandated scheme aims to involve, at least initially, non-government enterprises is not comforting at all to the old-school liberal, because its basic nature is top-down, all-knowing, daddy-state control, a slightly more bureaucratized way or reaching those corporativist social aims of 80 years ago. And the worst thing to me is the aesthetic, how so 1930s retro this whole medical buttinskyism is turning out to be.

"So, what I expect to see, if the legislation is not either struck down or repealed, is a horrible adverse selection problem with individual and small group policies. More and more people will opt out if reasonably healthy, and pay the mandate. Then, when they get sick, they will get health insurance to treat their ills. Mandatory issue, no waiting periods, etc. But, the more people who opt out to do this, the worse the problem will be, with the insured population becoming sicker and sicker, and more and more expensive, driving up insurance costs, and forcing more and more people to opt out and pay the penalty instead. A vicious circle, with the equilibrium point likely being beyond the means of many. And individual and small group health insurance moving very quickly from an insurance model to a pre-paid medical expense model."

Yes. This is one reason the ACA, as written, is doomed.

"The reason that I asked the question above is that there has long been a suspicion that the legislation was intentionally designed to destroy the private health insurance market, driving us into a truly socialized medicine system."

The ACA, on its own terms, will fail. Obama and the Democrat are either too dumb to know it; too evil to care; both; or, giving them the benefit of the doubt, fully aware of the ticking time-bomb, but hopeful that once embedded and it fostered dependency by the middle-classes, future Congresses and presidents would "mend it, not end it."

It would be nice if people who are so brilliant would think about how best to deal with the problem of the millions of fellow Americans who are without health care because they have no insurance and can't afford to pay out of pocket . They make too much for medicare, they work for small companies/businesses who can't afford to cover workers.

I don't know enough about the subject -- why doesn't the govt. offer something for that group, i.e., just expand medicare? Because then employers would stop insuring their workers? What if no employers covered health insurance? What if everybody had to fend for themselves? You could either buy medical insurance or pay the doctor bill out of pocket. Free choice. Why not just get rid of medicare too?

Part of the problem with the whole system we have created is that doctors and insurance companies have formed a working arrangement to create prices. The individual has no power or voice in this system. There's really no freedom here or a real market economy.

Everyone's "young and healthy" until the day they are not. Which is why it's called "insurance".

My young, healthy son incurred a seriously nasty sports injury that required extensive and expensive (even with great insurance) surgery.

He is 25. He is also still on our insurance, thank God. Because so often, the qualifier that follows "young" and "healthy" is "shortsighted".

That said, yes, there's no getting around the fact that this mandate creates a law one must follow or be penalized, in which case, if you refuse to buy in, you are breaking the law and therefore penalized.

The penalty isn't the point.

If a man holds up a liquor store with a gun, is caught, tried, convicted and sentenced, he's a lawbreaker long after he's fulfilled his sentence. Or, for that matter -- a child molester -- he's considered a lawbreaker for life.

That a person has not purchased insurance and has been penalized will no doubt be recorded somewhere and used to the detriment of that person going forward, so that whole "once the penalty is paid, you're not a lawbreaker" is bullshit.

Say, for example, two people incur traumatic injuries in a car accident. One has purchased insurance, one has opted out and paid the penalty. Which one will be left on a gurney in the hallway to wait for services and which will be flagged through for immediate treatment?

The penalty for not purchasing insurance is going to be much more than $95.00 in the long run.

"Well, if you're not sure, read the pertinent section of the law for yourself (that's what I did, we can't all be as lazy as Althouse and rely on Wikipedia), its on the intertube web."

I'm accepting your excerpt that you read and posted. My question is why you would support such a thing. It's clearly designed to deceive us into losing private insurance so that the public option, regardless of how it overbearing it gets, will be the only alternative. The law can't remain as it is; it's nonsense designed only to get passed - to get the wooden horse in the gate. That's exactly the strategy that Obama clearly promised before the election in widely viewed videos.

Do you not care you are being lied to, or are you cool with it because it fits your ideology?

One way to defend the law is simply to say that a requirement to purchase insurance or any other product sold in interstate commerce is obviously a regulation of that commerce.

It's my understanding, that currently Health insurance isnt an interstate product. It is regulated at the state level. Allowing it to be interstate, which was a GOP recommendation would increase competition, lower admin costs and reduce rates. Dems opposed it.

... Speeding is a criminal violation. Granted, most are dealt with with simply a fine, but if you are going too fast or accumulate too many speeding tickets there are other sanctions such as losing your license of [sic] if the speed is reckless, even ending up in jail.

So your analogy is bad.

Actually, Freder, you nicely complete the analogy.

Who defines whether an infraction is a criminal or civil? You propose, for speeding at least, that who defines the offense and who determines the penalty is irrelevant, immutable and the same in every jurisdiction. You assume Humpty Dumpty was right about meaning: "It means what they say it means."

So consider what it is that stops the health care penalty from growing if you accumulate more than one year's violation of the mandate? Faith in the Congress and the President.

IOW: Nothing. It means what they say it means, and it had to be passed in order to find out what it meant when they meant it. They didn't know, and don't care.

Your thinking is bad.

Understanding that the point isn't health care, but government power, will be your first tiny step toward rehabilitation.

My question is why you would support such a thing. It's clearly designed to deceive us into losing private insurance so that the public option, regardless of how it overbearing it gets, will be the only alternative.

I really don't support the law as written--my preferred solution is Medicare (or a government chartered single payer) for everyone. And I say this because I have lived in countries that have universal coverage and they are far superior to the mess we have here.

The law states that, beginning in 2014, individuals must ensure that they and their dependents are covered by health insurance. Taxpayers who do not meet this requirement will have to pay a penalty that the law calls a “shared responsibility payment.” It begins at $95 for the first year and never exceeds 21 / 2 percent of anyone’s annual taxable income.

A large majority of Americans, of course, have health insurance through their employers, Medicare or Medicaid and are already in compliance with this requirement. Given the relatively modest payment required of those who choose not to maintain insurance, no one is being forced to buy a product they don’t want.

The challengers argue that the mandate is a binding requirement that makes anyone who goes without insurance a lawbreaker. The government has determined, however, that those who pay the penalty, like those who are exempt from the penalty, are not lawbreakers. As a practical matter, the so-called mandate is just a relatively modest financial incentive to have health insurance.

A lot of questionable things in this. Sure, a lot of people are covered by insurance from work. BUT, much of that coverage is not compliant - remember all those waivers given to politically connected organizations? A lot of those waivers were requested because the policies were not compliant with the requirements of this law. For example, they may have a high deductible, or may have relatively low caps on maximum payouts. That sort of thing. These policies were provided by insurance companies that cannot afford to pay for higher benefit, higher limit, and lower deductible plans - such as those offered by restaurants and other employers that do not pay all that much. If you are paying someone $10 an hour, it is much harder to justify paying another, say, $5 an hour, for health insurance, as contrasted with a law firm that pays much higher wages. A lot of these companies are going to be given the choice of paying lower wages, hiring fewer employees, or, again, paying the required penalties (which, ultimately is a cost of employment, which translates into either or both of the other two alternatives). These plans are slated to disappear, in the implementation of the one-size-fits-all health care insurance legislation.

The note of Medicare and Medicaid is illustrative, and contrary to his later point about socialized medicine - no surprise that the socialized portion of national health insurance is compliant. It doesn't have to deal with the laws of supply and demand.

And, yes, no one is being "forced" to have health insurance. So what? People are being forced to either buy it or pay a penalty if they don't. Not much different.

And, the "lawbreaker" mention there is pure red herring. The fact that the IRS isn't supposed to be able to go after you for non-payment of the penalty is pure window dressing. When you refuse to pay it, when filing your income tax return, the IRS will just switch the money you paid around, treat the money you paid as going to the mandate, and go after you for non-payment of rest of the money you owe any way, if enough people just don't pay the penalty.

"I have lived in countries that have universal coverage and they are far superior to the mess we have here."

That depends on who you are, what you need, and when you need it. I have looked at the wait times and results of other systems, and in my particular case, I would have almost certainly died twice in last five years alone without my insurance and the access to the best medicine in the world which it provided error free at a reasonable cost,and most importantly, in time.

I'm at least as offended by your mother being a breeder as you are, but why haven't you done anything to rectify her unethical lapse? You're complicit in the crime, as long as you continue to enjoy the effects of it.

If we have a national retirement system we can have a national health care system. Should the feds create a system to do this or incentivize the states to do it.If the people are absorbing the cost of the free loading uninsured, then the free loading uninsured would be absorbing the cost of the obese if the uninsured are required to make payments.

There is a vested interest that all lifestyles illnesses be prevented instead of cured so that the correct person pays the cost fairly.

Dellinger misses the simple argument most likely to win the day in court:

If it is within the government's constitutional power to incentivize behavior with tax credits, how can it not be within its power to disincentive behavior with penalties?

"So Obamacare doesn't work to get the uninsured insured, it just gives the federal government a new source of revenue."

That's the byzantine Catch-22 which Dellinger's debunking also whiffs:

If, as proponents argue, the mandated coverage needed to increase the pool of the insured is the sine qua non of Obamacare, it follows that the entire scheme will collapse, if the uninsured choose to make a "modest" contribution to the federal slush pile, instead of actually paying into the healthcare system. They can still ("inevitably") rely on emergency room services to the same putatively consequential effect, of course, and still pin the same hopes on the benefits they are supposedly funding with the 1.45% of wages included in their FICA taxes.

When I described the persons screwed by Obamacare as "those who are healthy, single, childfree, young, male, risk-takers, living overseas who are vegetarians that prefer natural remedies," I wasn't thinking of Adolph Hitler, who was all of those things. He didn't even cheat on his non-wife, as opposed to FDR who was continually violating his sacred matrimony!

As to some of the side effects of Obamacare:

Facebook, Apple, Microsoft and Dell in their infancy sensibly tried not to hire sick, old folks or breeding females. When they were small businesses, they could legally avoid such burdens to the bottom line that promised to compromise their progress.

Once with over 50 or so employees, however, they are forced to pretend to observe "fair" hiring practices. If Obamacare is instituted and enforced, we will need to say bye, bye to USSA entrepeneurship. A Gates, Zuckerberg, Dell or Jobs would have to seriously consider establishing his plant in a country where he could safely hire, without paying health insurance, only those young, single, childfree, risk-taking men he really wants and needs. It's no coincidence that almost none of progress in IT has been accomplished by old farts or breeding females.

Re the comment that I was lazy to look up the provisions on Wikipedia... how about the lazy legislators who voted for the damned thing without reading it and while asserting that there was no point in attempting to read it and said crazy things like "We have to pass the bill so you can find out what is in it"?

The idea that after all this time people don't really know what it is... and yet, oddly, a big majority thinks it's unconstitutional... though they haven't read Raich or any of the other key cases!

Well, it's a big stew of ignorance, but people just seem to "know" things. But one thing we really do know is that the Democrats who passed it relied on this lack of knowing.

Actually, Mr. Hayden, the insurance companies successfully lobbied to not make coverage available through the existing government health plans (available to federal employees and Congress.) They make more money this way. And I'm not going to include a citation for that because I've got a headache. It may be an unsatisfactory excuse, but it's mine.

Frederson: re "lawbreaking," etc. it's my opinion you're arguing from the wrong platform. Look up terms like "mens rea," and "crime" in Black's Law Dictionary. And if you really want to understand it in lawerly terms (oh, woe!), take a gander into "Criminal Law," LaFave, West Publishing, St. Paul, MN. It's the standard text.

I believe that high deductible plans and HSAs are outlawed, so the law is bound to increase aggregate health spending (which O says is too high already) and limit options for consumers.

Which is why that famous pundit, Sarah Palin, brought the term "death panels" to the national debate.

The only possible way to keep costs down in such an environment is through rationing. Sure, some of it is being done right now with health insurance companies. But, the reality is that you have legal recourse when they do it badly. I have had to threaten to sue health insurance companies, but when my threats were not egregious, they backed down. There is no legal recourse when the federal government does the rationing. Unless you are close to members of the ruling elite.

Let me add that the government is nowhere near having the capabilities to determine what is effective and economic treatment, and what is not. This is highly complex, and those involved in the government do not seem to understand either the complexities or the subtleties of the problem. Rather, they seem much more willing to take the political route - giving Ms. Flake her free contraceptives, primarily because she is a member of a powerful liberal constituency (what Rush calls "feminazis).

We have seen plenty of evidence of what happens when the government gets into the business of deciding what is cost effective treatments. For example, having more MRI machines in medium sized cities in this country, than in entire provinces in Canada (and much newer ones too).

Nothing in the health-care law tells doctors what they must say to patients or how those patients are to be treated. It only requires people to either have insurance coverage or pay a modest tax penalty

OMB director Jeffrey Zients recently asserted that the penalty is NOT a tax.

Well I'm freakin confused. I'm in my 5th decade, don't have health insurance and don't want it. The early days of obamacare legislation included a jail penalty and after that language was removed I called Feingold's office and asked, "If I file and pay income tax, but don't have HI, will I be labelled a tax evader and have property seized?" The answer amounted to ahhhhhh...don't know.

So now there seems to be an unenforceable penalty, of *only* $95/year. That's 2-3 weeks of grocery money, or one nice spring month of electricity for me.

Then we have WI voter ID, where libs tell us people can't afford the $100 it may take to get a copy of a birth certificate to get the ID, and therefore voter ID is (in their extreme language) a poll tax.

This country has gotten so screwed I think Beck is correct: up is down, down is up. I really, really pray SCOTUS tosses this whole mess. Thank you Ann, for allowing me to comment on your blog.

I have lived for over 20 years in a country with "free" health care - Canada. It was not superior.http://otherclub.blogspot.com/2010/02/canada-health-care-retrospective.html

Freder- the fact that the law can change is something your argument, and especially your criticism of the analogy, must respond to, to be sensible. There weren't "points" for speeding when the speeding laws were first passed, and you couldn't have predicted them. Now, there are "points" and they can help you predict how Obamacare will go wrong if it isn't stopped. Appealing to some other law you prefer, but that doesn't exist, doesn't get you get of it.

Actually, Mr. Hayden, the insurance companies successfully lobbied to not make coverage available through the existing government health plans (available to federal employees and Congress.) They make more money this way. And I'm not going to include a citation for that because I've got a headache. It may be an unsatisfactory excuse, but it's mine.

Agreed as to the lobbying, but not sure if you have the motives right. The legislation sneaked through on a narrow enough margin (and using legislative tricks) that having the health insurance companies, plus the AMA, drug companies, etc., actively working against them, likely would have meant defeat for the legislation. From that point of view, the legislation was even more sausage making than usual.

I frankly don't think that they would have had anywhere near a majority in either House of Congress, if they had tried for full socialization of health care and health care insurance. It passed with a razer thin margin as it was.

leslyn said... Actually, Mr. Hayden, the insurance companies successfully lobbied to not make coverage available through the existing government health plans (available to federal employees and Congress.) They make more money this way

The wife is a Fed. You understand that the Federal Employee Health Benefit Plans are just a wrapper (mark-up) around private insurnce from BCBS, UHC, Kaiser, etc?

google FEHB

only the President, prisoners and the military really get Federal healthcare.

I would have almost certainly died twice in last five years alone without my insurance

I have no idea what your particular health issues are or were, so I have no way to judge the truth of your assertion. I don't know what research you did, but you are most likely wrong about your chance of survival.

And what if you didn't have insurance? If you weren't dead, you would almost certainly be bankrupt.

Facebook, Apple, Microsoft and Dell in their infancy sensibly tried not to hire sick, old folks or breeding females. When they were small businesses, they could legally avoid such burdens to the bottom line that promised to compromise their progress.

This is an interesting point. There will be hiring decisions made, at least in part, on the basis of age, sex, marital status, sexual orientation, and health, because of this legislation. Mostly not egregiously enough that the rejected applicants would have a cause of action. But, at the margins. If you have two applicants with close to the same qualifications, one male and one female, both in, say, their mid-20s, why not give the qualifications for the guy a little more weight, hire him, and save the cost of paying for all the woman's plumbing problems? This doesn't work very well when you are big enough to have an HR department, but small businesses provide a lot of jobs, and are where big companies come from.

my preferred solution is MedicareThose who work already shoulder most of the cost of Medicare. Shall we have retirees pay for workers' Medicare, or maybe college students and pre-schoolers (they will eventually)? And what happens when Congress cuts Medicare outlays, as this bill did?

Like higher education, the more Govt throws money at health care, the more ridiculously expensive it becomes. At least the latter has more to show for it than March Madness.

When they were small businesses, they could legally avoid such burdens to the bottom line that promised to compromise their progress.

Actually once they employed a relatively small number of people (I think the threshold is 15) they couldn't legally avoid such burdens. EEOC and ADA would have been applicable to them and deliberately refusing to hire someone based on age, marital status, or pregnancy is prohibited. Of course proving that you didn't get a job because of it is extremely difficult. (Unless the hiring manager does something really stupid like say "we would love to bring you on but we don't hire pregnant women"

Actually, administration costs of Medicare and Medicaid are around 3%. You must be thinking of private insurance (and that is actually closer to 10% for most).

The comparison between private and government funded administrative costs is apples and oranges. For them to be comparable they would have to operate under the same fiduciary reporting rules, which they don’t. Even if they did, the comparison would still be dubious without taking into account, among other things, the demographics of each of the entities subscribers. For example, Medicare (old age and disability) serves a demographic that consumes a much larger slice of the pie than would a private insurance entity on a per capita basis.

For the sake of argument assume the average claim of the private insurer is $100 and the average claim for Medicare is $200 due to demographic differences. Also assume that the private insurance spends $8 to service a claim while Medicare spends $10. As a percentage of the claim Medicare would appear to be more efficient when in fact it would be less efficient.

If you have two applicants with close to the same qualifications, one male and one female, both in, say, their mid-20s, why not give the qualifications for the guy a little more weight, hire him, and save the cost of paying for all the woman's plumbing problems?

Reminds me of the argument that God must have been an Aggie, since who else would have come up with the idea of installing a sewage system that passes right through the middle of the recreational area?

If you have two applicants with close to the same qualifications, one male and one female, both in, say, their mid-20s, why not give the qualifications for the guy a little more weight, hire him, and save the cost of paying for all the woman's plumbing problems?

If your want to do biz w/Uncle Sam, the women are a mark on the paper.

"If I file and pay income tax, but don't have HI, will I be labelled a tax evader and have property seized?"

It would appear, Gail, that you also will have to either lie on your tax return (a felony) or compelled to be a witness against yourself (i.e. "self-incriminate" yourself) by disclosing on the tax return that you do not have such "insurance."

And such latter admission on your tax return that you do not have insurance will, ipso facto, automatically incur a penal sanction, without any hearing or other due process.

"The Brits decided to fund the NHS from the general revenue, so there is still room for private health care and medical insurance services in the U.K.

The ACA attacks the insurance industry on the theory of Murphy's Golden Rule - "He who controls the gold gets to rule" - which does not leave room for any competition."

Actually, the NHS did allow private care until the health care workers' unions refused to care for hospitalized private patients. This was on the theory that they were "jumping the queue." It happened about 1979. The result was that Harley Street, private medicine, moved to Belgium. After the Labour health minister had her hysterestomy in Belgium, there was a scandal, the Thatcher was elected PM. She brought private care back with "Fund Holding."

The only thing that really matters in the end is what the SCOTUS decides. And I suppose that comes down to Anthony Kennedy. That's more interesting to me than what paid shills for Obamacare have to say anyway.

"I do know that dealing with a myriad of insurance companies is a nightmare for doctors. My friend, who is in a practice with eleven doctors, has three full-time employees to handle insurance claims."

Now, I know you don't know what you are talking (writing) about. My four surgeon group had 14 employees, most to handle insurance and Medicare billing. I eventually had to buy a computer billing system as I had around 175 different contracts, not counting Medicare, all with different provisions. I was once fined $500 for sending a patient to the "wrong" lab for a $16 test.

Nothing in the health-care law tells doctors what they must say to patients or how those patients are to be treated. It only requires people to either have insurance coverage or pay a modest tax penalty

OMB director Jeffrey Zients recently asserted that the penalty is NOT a tax.

Oh, it most assuredly is a tax. How do you think you will show compliance with ACA? On your federal tax return, of course.

With taxes, you won't go to jail right away if you don't pay them. You can let them accumulate for a few years before the IRS really comes down on you.

Similarly, if you choose not to pay the 'health care incentive fee', do you think the gov is just gonna wipe your slate clean at the end of the year? I doubt it. It will stay on your IRS record, likely accumulating interest if not also penalties. It will likely show up on a credit check.

So if it walks like a tax and quacks like a tax, it's a tax.

I was going to refer to one of my earlier posts in this thread, but I think it's been bounced. Probably not topical enough. That's Ann and the universe telling me to get back to doing my taxes, which we're trying to wade through today. If government health care is anything like the IRS, God help us all. I hope SCOTUS tosses the monstrosity in its entirety.

I agree that it is apropos to consider the Medicare situation, since many of its characteristics will apply to Obamacare:

Regarding Medicare:

The single and childfree Black Amerikan Man pays into the SS and Medicare system for 45 years and is, probably by design, expected to die just 4 years after beginning to collect the first dollar in SS and Medicare. Most of the proceeds of the ongoing 45-year theft of his income and wealth go, of course, to White Women who live to 79, to indolent spouses and children, and to (in great and accelerating numbers) "disabled" strangers.

I advise the single, childfree and forever oppressed Amerikan Black Male to: marry (and after 10 years, divorce) a series of young foreign women (white, brown, yellow or black) over the 40 to 50 years you are forced to pay socialist gummint SS and Medicare fees. Every one of those fillies will be OH SO HAPPY to show her appreciation for having you as a spouse, if only for gaining a green card, citizenship, preference for importing parents, siblings and children left behind, and Social Security benefits for themselves and their progeny--all paid from your account (and the accounts of all those young, single, risk-taking, non-breeding males too stupid to avoid working [can you believe serving in Afghanistan?] in our Socialist System).

Your arguments make about as much sense as Kathleen Sebelius saying that her contraception and sterilization surgery mandates are not attacks on people's religion because the President says so.

Everybody else,

If this thing stands, I do not see any way, but that the insurance companies will become Government front organizations like Fannie Mae and Freddie Mac, except that they will not be allowed any freewheeling "Wild West" period like Fannie and Freddie have had.

With Obamacare in place we should be able to dictate doctors salaries and where R&D money goes. All in the interest of making it fair. No doctor needs to make $400,000 a year. We could even make med schools free to the deserving. or at least a very low cost. Their education raises the health tide of the whole country. Couldn't be a better system out there.

So it is fascism rather than socialism as such, though of course fascism was billed as a variant alternative to out and out socialism.

No, Hagar. Fascism and Socialism are very different, as Uncle Milton would say:

Fascism would require that all your important life decisions be directly made by Obama. Socialism requires only that you be taxed within an inch of your existence and that you be subsidized once you learn to enjoy the food, sex, travel, cars and health care that Obama allots you, depending on your sex, age, race, marital and family statue, national origin, residence and sexual preference.

Re: the "conspiracy" theory that Obamacare is just phrase one and was made to fail. Someone said several years ago, something pretty close to "it may take 10 or 15 years but we'll eventually evolve into the single payer system we want." That psycho nut was.. Obama.

Speaking for myself, not Dellinger, I'll take a shot at explaining this:

"Dellinger asserts that the government has "determined" that someone who pays the penalty for failing to do something the law requires him to do is not "breaking the law.""

This is really a pivotal distinction, ISTM. The argument against the mandate as an exercise of commerce clause powers relies on challenging the unprecedented nature of "forcing" citizens to actively engage in commerce. The law itself, however, does not, in fact, compel anyone to do so, i.e. it is not illegal to go without insurance. You will never be charged with a crime or taken to court for declining to engage in the relevant economic activity. You will only be breaking the law if you refuse to pay the penalties assessed as a result. That is the only form of legal non-compliance implicated here. You are being compelled to pay a fine, you are not being compelled to make a purchase, as the opponents of Obamacare assert.

In a constitutional context, I don't think this is a distinction without a difference. While the law, as written, could have the same net effect as forced purchasing in some cases, it doesn't necessarily have that effect, because the choice is still the citizen consumer's to make. I can easily imagine the folks who wrote this legislation (in contradistinction to those who passed it!) arriving at this construction for the very purposes of passing constitutional muster. This wouldn't be the first opinion which has hinged on such seemingly semantic details.

Metacomment that demonstrates how I rise above the arguments here. Wry, self-depracating observation. Summary call for more elevated and self-aware discussion from all players, though no names named. Declaration that I won't necessarily return here.

So Obamacare doesn't work to get the uninsured insured, it just gives the federal government a new source of revenue.

Seems like it. We were lied to. The law, as sold to us by the bleeding hearts, was supposed to be about getting health insurance coverage for all those millions who are left dying in the streets because they have no health insurance. If that were true, they could have simply redesigned the Medicaid laws (maybe cut the bureaucracy by turning it into a voucher system for poor people to buy private health insurance.)

The number of uninsured who actually want to purchase insurance is probably smaller than those who are uninsured by choice -ie. those who prefer paying out of pocket, those who are young, healthy and single, and the free-riders. Now this guy is saying this law doesn't require anyone to buy insurance- they can just pay a penalty. So this law is not designed to increase coverage, but will simply be a burden on the lower middle class who will be compelled to take money from their limited budgets to buy insurance, or pay a penalty.

Meanwhile, these uninsured folks can buy insurance at whatever point they want, right? Apparently so. As you point out, the law actually encourages free-riders.

So what is this law about, if it is not about getting coverage for the uninsured or reducing the number of free-riders? More and more it looks like a system designed to destroy private insurance. I'm with Althouse. He won't debunk that myth because he can't.

This is the best post on the worrisome aspects of PPCA I have seen; mostly I've read Volokh which is more focsed on precedent and constitutional law nuances. It's ironic that Delinger is arguing the case; his name being a homonym for the most notorious bank robber of the thirties. This 'Delinger' OTOH seems, with his thirites analogies to be reassuring the justices, 'Don't you feel better with that warm smoke I am blowing up your..' There's somehow for me also the hint of the bad guy in the name which says, 'Accept the smoke or it's curtains for ya.'

"My sister says she had private insurance in addition to NHS, but that this now has become too expensive for her. I assume that meant for private doctors and private hospital/clinics."

Originally, private insurance was available to pay for additional amenities in NHS hospitals like private rooms and telephones. The unions stopped this. Now, as far as I know, it is only used in private hospitals, as in Belgium, etc. A large number of British middle class are emigrating to France and signing up for Securite' Sociale. France has now put a five year minimum residence requirement.

I know a few private specialty hospitals were built about 10 years ago but I don't think they did well. Probably there was not enough demand. I do know that 10 years ago, 25% of the population of greater London had private insurance. That was the only area, though

"The number of uninsured who actually want to purchase insurance is probably smaller than those who are uninsured by choice -ie. those who prefer paying out of pocket, those who are young, healthy and single, and the free-riders. "

Real catastrophic care insurance would be cheap and probably quite attractive to this age group. Obama care, of course, goes in the other direction of requiring all sorts of mandated coverage, which runs the cost up.

"With Obamacare in place we should be able to dictate doctors salaries and where R&D money goes."

That is what is happening now.

All in the interest of making it fair. No doctor needs to make $400,000 a year."

No lawyer needs to either.

"We could even make med schools free to the deserving. or at least a very low cost."

Medical schools are now taking steps to deal with loans, Stanford, for example, has decided to limit student dept to $90,000. Beyond that, the school plans to subsidize them. France has free medical school and few doctors have college education.

"Their education raises the health tide of the whole country. Couldn't be a better system out there."

I don't know what that means but I do know that Obamacare is not a system designed to work.

You are being compelled to pay a fine, you are not being compelled to make a purchase, as the opponents of Obamacare assert

You are being compelled to pay a fine for NOT making a purchase.

Suppose it is decided by Congress that everyone must own a Volt. But, since we all know Volts are very expensive, don't work all that well and many people can get around without a car or can get around with a different transporation arrangement..... many people will not buy a Volt.

Because you have NOT purchased the "mandatory Volt", the government can assess you a fine for the NON-purchase.

How is this not a forcing or a compulsion to participate in commerce that you do not want?

I'm late to the party, and didn't read all the comments, but an earlier one mentioned "Right now, people who go without insurance often shift the costs of their health care to other patients and taxpayers." I have this thought - and I don't see it elsewhere - that this is the crux of the issue. Obama once said "I don't want to see people go bankrupt because of healthcare costs," and I ask, why not? I should budget for my health insurance just like I do my food, gas and birth control (wait, what?). If I choose to go without insurance, and don't have the money for health care, then instead of hanging the cost on the taxpayers, my provider (the emergency room, for instance) should have the right to go after my earnings, my possessions, etc. Why can't health insurance be like life insurance? Why can't I start paying for my daughter's health insurance from day zero, have her take over the payments when she's an adult, and as long as you pay your insurance you keep your insurance.

For a law professor, you sure don't know much about the law. Speeding is a criminal violation. Granted, most are dealt with with simply a fine, but if you are going too fast or accumulate too many speeding tickets there are other sanctions such as losing your license of if the speed is reckless, even ending up in jail.

...and if you refuse to pay the penalty (which should be allowed since it's not a criminal act and Democrats have said, repeatedly, it's not a tax) --- then what?

And how exactly do you debunk a myth--or even bother trying--that has no basis in fact and is just the fevered rambling of right-wing talk show hosts?

OK. On what grounds can the government force you to pay a fine for something for no reason? Since you don't have to pay insurance, where is the legal justification for the fine in the first place?

Dance now.

The health-care case is a test of Congress’s power under the Constitution to regulate commerce among the states. One way to defend the law is simply to say that a requirement to purchase insurance or any other product sold in interstate commerce is obviously a regulation of that commerce...

Is the writer serious?

Insurance CANNOT be interstate because federal law forbids selling across state lines (which would actually lower premiums nicely).

From now on, when someone calls me a pedophile on this blog (which a couple of immature posters have taken to the last couple of days), I will demand that you tell them to retract the statement. If you don't I will just assume you agree with them.

Given that YOU specifically called her out on the issue....your analogy is bad.

I really don't support the law as written--my preferred solution is Medicare (or a government chartered single payer) for everyone. And I say this because I have lived in countries that have universal coverage and they are far superior to the mess we have here.

Provided you don't need a specialist on short notice. Then, well, good luck.

Or if it's vacation season. France had, what, 10,000 elderly die just a decade ago due to a heat wave during vacation?

I don't know what research you did, but you are most likely wrong about your chance of survival.

How much of an insufferable prick must somebody be to say somebody is lying about their personal situation with absolutely no knowledge?

I do know that dealing with a myriad of insurance companies is a nightmare for doctors. My friend, who is in a practice with eleven doctors, has three full-time employees to handle insurance claims.

That could be eliminated by allowing policies to be sold across state lines (which would actually make it interstate commerce). Any ideas who opposes it?

OMB director Jeffrey Zients recently asserted that the penalty is NOT a tax.

Real catastrophic care insurance would be cheap and probably quite attractive to this age group. Obama care, of course, goes in the other direction of requiring all sorts of mandated coverage, which runs the cost up.

Real catastrophic insurance is attractive to many other groups.

Myself as an example. I'm over 60 and have no health issues (knock wood), take no medications, see the doctor whenever I have a problem, usually something minor like a cold or recently a broken toe. I pay cash for my medical care and pay cash for my routine checkups.

Why do I want to pay for a bells and whistles policy when I only need coverage for the catastrophies beyond my current financial ability to pay?

Why would I want a policy that covers birth control or maternity? If I became pregnant it would be a genuine miracle worthy of the National Enquirer.

Like my Volt example. Obamacare wants to mandate that I buy an expensive, and useless to me, Volt instead of letting me chose to buy a car that suits my needs or even no car at all if I don't need a car and can pay for a taxi.

"I don't want to see people go bankrupt because of healthcare costs," and I ask, why not?

But if you go bankrupt, the cost is still shifted to somebody else--in fact that is the result of bankruptcy, your creditors are unable to collect what you owe them. So how does bankruptcy solve the problem you claim you are solving?

How much of an insufferable prick must somebody be to say somebody is lying about their personal situation with absolutely no knowledge?

Unless he is willing to share what his condition is that can only be treated in the U.S., I am dubious. People are not free just to make unsupported assertions and have all of us accept it as the gospel truth.

Unless he is willing to share what his condition is that can only be treated in the U.S., I am dubious. People are not free just to make unsupported assertions and have all of us accept it as the gospel truth.

But if you go bankrupt, the cost is still shifted to somebody else--in fact that is the result of bankruptcy, your creditors are unable to collect what you owe them. So how does bankruptcy solve the problem you claim you are solving?

Then do something the government is unable to do:

Explain, exactly, where the government's power has any limits.

Why CAN'T they force you to buy a car of their choice and fine you if you do not?

Why CAN'T they insist on you getting a license to speak freely and fine you if you do not?

And how does this not bother Progressives, but demanding ID for voting is an unfair financial burden?

That's funny. Especially considering that I am apparently the only one in this entire discussion (Althouse included) who bothered to look up, read and post the actual part of the law we are discussing.

Your numbers don't make any sense--you are claiming 26.7 million people out of 22.3 million made more than $50K a year.

So, you're attempting to claim that the 9.1M who made over $75,000/yr weren't included in the number who made less than $50,000? It was a figure to show how much money the uninsured were making (with "people making over $50,000/yr" being the fastest growing group of uninsured).

If you have two applicants with close to the same qualifications, one male and one female, both in, say, their mid-20s, why not give the qualifications for the guy a little more weight, hire him, and save the cost of paying for all the woman's plumbing problems?

If your want to do biz w/Uncle Sam, the women are a mark on the paper.

You may have missed this in my suggestion, but the next sentence was:

This doesn't work very well when you are big enough to have an HR department, but small businesses provide a lot of jobs, and are where big companies come from.

Mostly, the government does not hire small businesses, and, in particular, businesses small enough to not have an HR department. (I say "mostly", because a bit over 20 years ago, my ex and I had a company that subcontracted our labor to a minority contractor to the government - but that is rare).

Actually, administration costs of Medicare and Medicaid are around 3%. You must be thinking of private insurance (and that is actually closer to 10% for most).

The comparison between private and government funded administrative costs is apples and oranges.

Another part of the "apples and oranges" is that these government programs trade low overhead for massive fraud - fraud that is probably higher than the overhead costs of those private insurance companies.

So, you're attempting to claim that the 9.1M who made over $75,000/yr weren't included in the number who made less than $50,000?

The way you phrased it, it was unclear. I was not attempting to claim anything, I was asking for a clarification. And now that you have cleared it up your numbers still don't make sense (I am assuming that the point is anyone who makes 50K a year could afford health insurance if they wanted to). 22.3M - 17.6M is 4.7M, not the 8.2M you claimed.

I said:The number of uninsured who actually want to purchase insurance is probably smaller than those who are uninsured by choice

Freder said:Do you have any evidence or statistics to support this assertion or is it just something you instinctively know?

Wouldn't you have to suppose that many or most of those uninsured are doing so by choice, in order for the idea behind the mandate to work? If you believe that all or most of the uninsured cannot currently afford to buy insurance, how can mandating them to do so or pay a fine, in any way not be a burden to them? How does this law help them?

The theory is to force the young and healthy who can afford to pay, but choose not to, into the system, so that a larger pool will bring down costs. But since the law is designed such that these folks can decide to pay the cheaper penalty instead, until they need insurance, insurance premiums will likely go up. Either they have set it up to fail for some reason, or they are morons.

And even if the law was reworked so that insurance rates do go down, there will always be people who do not qualify for medicaid, and cannot afford to buy insurance at some time or other w/o it placing a burden on their families. Forcing them by law to do so or pay a penalty does not help them. This law is a fraud.

"Another part of the "apples and oranges" is that these government programs trade low overhead for massive fraud - fraud that is probably higher than the overhead costs of those private insurance companies."

True.

They are also more restrictive on benefits than private coverage, i.e., utilization controls for public payers have been established by bright-line policies as to what is covered, when it is covered, and how much will be reimbursed.

That said, both Medicare and Medicaid are extraordinarily wasteful, notwithstanding their low administrative costs, much less effective and much more expensive than originally thought/promised by Democrats when enacting them.

Expectations for effectiveness and cost for the ACA will prove, should it stand, equally doomed.

@12:58 I'm also stuck on how much oversight and enforcement is going to cost. How many thousands of new jobs will be created just for "insurance verification", "penalty assessment" and collection enforcement -- jobs that have no reason to exist yet taxpayers must fund. Idiotic!

Someone needs to inform the left that the perpetual motion machine is impossible.

@1:59 pm The reason that I asked the question above is that there has long been a suspicion that the legislation was intentionally designed to destroy the private health insurance market, driving us into a truly socialized medicine system.

"In 2005, Medicare's administrative costs were $509 per primary beneficiary, compared to private-sector administrative costs of $453. In the years from 2000 to 2005, Medicare's administrative costs per beneficiary were consistently higher than that for private insurance, ranging from 5 to 48 percent higher, depending on the year (see Table 1). This is despite the fact that private-sector "administrative" costs include state health insurance premium taxes of up to 4 percent (averaging around 2 percent, depending on the state)--an expense from which Medicare is exempt--as well as the cost of non-claim health care expenses, such as disease management and on-call nurse consultation services."

@2:58 Bagho: I would have almost certainly died twice in last five years alone without my insurance.

Fredo: I have no idea what your particular health issues are or were, so I have no way to judge the truth of your assertion. I don't know what research you did, but you are most likely wrong about your chance of survival.

You have been on this list for how long Fredder? And Bagho has referred to his situation a couple times over the past couple years in some of the health care & insurance discussions? And you never bothered to follow up on it?

You qualify for being disqualified as a regular here.

I don't know what research you did, but you are most likely wrong about your chance of survival.

This is not an argument about whether the ACA will be beneficial or not. I am certain it will benefit some, impinge on others, but for most people will be utterly meaningless. The underlying debate about the ACA isnt about healthcare, or costs, or insurance, its about the scope and powers of Government. If the Feds can mandate health insurance coverages, dictate the scope of policies offered and coverages allowed, costs to the insurer and costs to the consumer, then they can force us to do anything they feel is beneficial to us all. After all, once its been established that the Congress can order you, an individual citizen, to comply with a Federal law in this way, they can also force you to exercise, (on their schedule, because why should they let you have the freedom to decide how much exercise you really need to do?) force you to diet, (because the government has a vested interest in your health and well being, since you are a valuable tax revenue generation machine); force you to have a certain number of children (because there are too many of your kind, not enough of other race/ethnicity/gender in the population) or no children at all; force you to purchase only government approved foods, force you to purchase only government approved transportation, force you to live only where they want you to live, force you to work in the job that the Administration has determined is the best fit for your talents regardless of your wishes or desires, force you to serve in a military capacity regardless of your conscience, and eventually force you to die so as to not be an enormous burden on the health care system.

Our freedoms as individuals is at stake here, and while there are some who would gladly trade all their freedoms and mine for some comfort in knowing they will have guaranteed health care, I will NOT trade my freedom for their peace of mind.

If we are going to count up the costs, what do you suppose the costs will be when people decide that they have had enough of the dictatorship of the do-gooders and just drop out entirely? No violent overthrow, no civil war, just drop off the grid and never ever contribute a penny to their schemes? How will the government respond to such people? With ever more force and coercion.

A lot of good comments. My take away which I'll have to verify, is that for someone with good health, and not a big income, who has been paying for their own catastrophic coverage with huge deductible, it makes sense in 2014 to let the policy lapse and pay the fine or 2.5% of taxable income. In the event of illness then get insurance since there will be no penalty for preexisting conditions. Otherwise I will be hit with extraordinarily massive increases in premiums as I approach 65, to cover the unhealthy who now will have to be covered but do not have to pay extra. Since the healthy get no incentive to be insured, what's the point? Is that called gaming the system or not wanting to be a total schmo?

Make that total Shmoo -- and look here for the Shmoo legend According to Shmoo legend, the lovable creature laid eggs, gave milk and died of sheer esctasy when looked at with hunger... Ironically, the lovable and selfless Shmoos ultimately brought misery to humankind because people with a limitless supply of self-sacrificing Shmoos stopped working and society broke down.

""For example, do you feel "forced" to follow the speed limit? Would Dellinger say you're not forced, because you have the option of paying speeding tickets?""

"For a law professor, you sure don't know much about the law. Speeding is a criminal violation. Granted, most are dealt with with simply a fine, but if you are going too fast or accumulate too many speeding tickets there are other sanctions such as losing your license of if the speed is reckless, even ending up in jail.

So your analogy is bad.

3/24/12 12:25 PM"

For an imbecile criticizing a respected law prof., you don't know anything about law or even analogies (apparently). As an actual lawyer (i.e., not one who pretends on blogs) a traffic violation such as speeding is NOT a criminal violation; it's a traffic violation. It doesn't even fall under the criminal title in my states code. Next time you want to act like a jack ass, head over to the MesSMBC blog where facts are discouraged - you'll fit right in.

As I discuss in Part III of my book Never Allow A Crisis To Go To Waste, Obamacare (and Mr. Obama's "clean energy economy plan) are faithful implementations of German Zwangswirtshaft socialism where the government allows an industry to remain in nominal private ownership but abuses its police, taxing and spending powers to direct what products will be produced, business administration and how they will be sold.

And now that you have cleared it up your numbers still don't make sense (I am assuming that the point is anyone who makes 50K a year could afford health insurance if they wanted to). 22.3M - 17.6M is 4.7M, not the 8.2M you claimed.

In a stunning turn of events, a person can actually be in more than one group at a time...

@sglaw:Why insult Frederson ("imbecile") for not having the same education and expertise you do? That's not a level playing field.

Frederson is relying on a common perception, among people who are not criminal lawyers, that speeding is a crime because it breaks the law and they are subject to a penalty. That is, in fact, very close to the legal definition of a crime.

The fact that he has not been privileged to delve into the hornbooks and make the distinctions between classifications of offenses should not, IMO, subject him to ridicule. I daresay he knows a lot more about physics than you do, and would be more polite about it.

Nice work, Ms. Althouse. We also go after Dellinger's myths, #'s 3-5 as well, over at biasbreakdown.com today. Amazing that someone who reached such a high ranking position in government would feel comfortable using such disingenuous logic.. not surprising though.

It is not an insult if it's accurate. Moreover, if he is going to pop off on legal matters, he is going to be subjected to criticism when he is wrong. In other words, ignorance is not a defense in law or in debate. Notice also, I'm not popping off on physics blogs about physics. But, you probably assumed that. Nevertheless you chose to engage in a little sophistry.